The Ethics of Physician-Assisted Suicide

Abstract

Physician-assisted suicide is a highly controversial topic around the world and is only legal in seven countries as a whole and seven states in the US along with the District of Columbia. The controversy stems from the debate on whether the patient has a right to end their own life. Historically, suicide was seen as a sin since only God had the right to determine when a person was to die, and since many western countries practiced Christianity which said it was a crime, laws were put into place to punish those who attempted to take their own life or who helped others to do so. Nowadays in the US there is separation of church and state where religion isnt supposed to influence laws. Without considering the religious aspect, is assisted suicide ethical?

Keywords: Assisted suicide, physician-assisted suicide, ethics, utilitarianism, Kantianism, euthanasia, right to life, death with dignity, self-murder

The Ethics of Physician-Assisted Suicide

What constitutes as murder? According to Matthew Lu, there are three different criteria that need to be met in order for the action of taking another human beingr's life to be considered murder; (1) it must be an intentional act, (2) the victim must be a person, and (3) the victim be morally innocent (Lu, 2017). If all three of these points must be met for the death of a human to be considered murder then would suicide be considered murder as well? First, one can assume that it is an intentional act with no outside factors influencing or coercing the individual; second, the victim is a person; and third, he or she is morally innocent, as in they are not being punished for committing a crime or killed while causing harm to another individual. Suicide fits all three criteria and therefore can be considered a form of murder based on this definition along with all other types of assisted suicides as well. Since murder is never acceptable, then according to that logic, suicide and all other forms of it are technically ethically wrong as well.

Part 1) Arguments for euthanasia/PAS

Euthanasia is the practice of painlessly killing a patient with the intention of ending pain and suffering, usually from a terminal illness or when their quality of life has declined more than they can endure. The word comes from the Greek eu- good or well and Thanatos- death to mean a good or easy death (Euthanasia, n.d.) and it can be either a passive or an active deed. Passive euthanasia is where a patient is purposfully not given medication or treatment that could potentially prolong their life and they pass away when it is naturally their time to go, where as active euthanasia is the intentional act ending oner's life and is usually aided by a medical professional which gave rise to the term physician-assisted suicide or PAS. Although the terms are often used interchangeably, there is a slight difference between the two; euthanasia is where a second party is the one to administer the cause of death while in physician-assisted suicide the second party only gives the patient the means to end their life, but they dont actively do the killing themselves. The passive form of euthanasia is mostly accepted by the public and is even protected by American law when the U.S. Supreme Court ruled in 1990 that competent adults have the right to refuse medical treatment while active euthanasia has no federal regulation and is left to each individual state to determine whether or not it should be allowed (Ardelt, n.d.).

In 1997, Oregon was the first U.S. state to permit active euthanasia with the Death with Dignity Act which allowed a physician to prescribe a lethal dose of medication to a patient who would self-administer it with the intention of ending their life. The proposal of the act was met with heavy pushback at the time but it prevailed with a majority vote and was enacted into state law

Real examples. (Oregon death with dignity)

Avoidance of pain. Utilitarian arguments. Doesnt the person who is actually suffering have the greatest say in whatr's best for their situation? Should competent terminal patients be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.

Autonomy or my life. arguments.

Part 2) Arguments against euthanasia/PAS

Give real life examples.

Slippery-slope) Netherland now allows patients diagnosed with dementia to commit physician assisted suicide before they begin showing symptoms. Because of the nature of the disease the victims will lose cognitive capabilities before the physical pain sets in. Can we justify killing for the sake of future pain? In any given lifetime pain is to be expected. Would it not be allowed then for all lives to be cut short before they can experience pain?

What if the physician is against it? Would it be required of all doctors that they would be forced to participate if itr's the patientr's wish? Would there be a specialist whor's not against it who comes and performs it? Doctors take the Hippocratic Oath and vow But it may also be within my power to take a life, this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play God, Does this violate that?

Where is the line that separates relief from dying and killing?

Since suicide is done to one-self it seems like it must be intentional, but can a person with severe mental illness make that decision for themselves? Punishment for murder can be avoided by the plea not guilty for reason of insanity (NGRI). If a patient has a severe mental disability, can they be held accountable for taking their own life?

Although utilitarian arguments could be made for pro side. Murder is wrong from a Utilitarian view point. Could you justify someone elser's death to avoid pain?

Murder is wrong from a Kantianism view point. Autonomy gives us the right not to be coerced. It does not give you the right to life or the right to take life. Again, passive vs. active

Suicide is self-murder, murder is wrong, ergo suicide is wrong according to ethics

Conclusion

Reflect on thesis. And wrap-up the point.

Express understanding and sympathy.

Emotions do not determine ethics. Finish with Kantian reasoning.

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